Prevention of Stroke(Part 2)

Prevention 

Have medical check-up regularly

Even if you have not been experiencing a medical problem in the last few months or years, it is necessary that you see your physician for medical check-up. In this process, one of the things that he will evaluate is the condition of your heart. He could listen to your heart sounds, and he could find out if you have the so-called atrial fibrillation (AF). If he suspects that you have AF, he will request for electrocardiogram (ECG) test, and it will confirm if you really have the said problem. If so, your physician will either give you medicine to control your AF, or he will refer you to a cardiologist. There is a need to control your AF because, as mentioned in the preceding, it could cause stroke due to cerebral embolism.

Have your blood pressure checked regularly

As mentioned in the preceding, your blood vessels in the brain are so thin that they cannot withstand high blood pressure. Thus, it is necessary that you must check your blood pressure regularly. If elevated and above the normal values, you need to take some medications. During your medical check-up, bring up the matter to your physician for proper and necessary prescriptions. You need to control your blood pressure at all times to avoid having stroke due to ruptured blood vessel in the brain.

Have annual evaluation of your blood chemistry

In your medical check-up, one of the important things that your physician will request you to do is to have blood chemistry examination. The basic components of this test are: fasting blood sugar, blood urea nitrogen, blood creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood uric acid, and the lipid profile test which determines the levels of your cholesterol, triglycerides, high-density lipoprotein, and low-density lipoproteincholesterol. Under the topic of preventing stroke, however, the most important  components of blood chemistry that you need to pay attention to are the fasting blood sugar and the lipid profile. If you have a family history of diabetes mellitus, you should know the level of your fasting blood sugar annually, and keep track of the trend. If it increases every year, then you need to alter and modify your lifestyle, such as your diet and your daily physical exercises.Under the lipid profile test, you should know the level of your blood cholesterol; and if it is elevated, consult your physician for dietary advice and prescription(s) of necessary drugs.

Refrain from smoking

Cigarette smokinghas been scientifically established as the root cause of several medical problems, such as cancer in the lungs. In relation to stroke, however, it has been established, too, that it accelerates the development of the so-called atherosclerosis, which is the deposition of fatty substances along the inner lining of your blood vessels. Consequently, you will develop hypertension which could lead to stroke. If you have not started smoking yet, never start doing it. If you have been smoking, stop the habit as soon as possible.

Refrain from taking high-salt and high-fat diet

If youtake meals and foodsrich in salt, or sodium, your blood pressure will rise up—much more if you are over 40 years old. Thus, before you take any food item, especially the packed ones, look at the sodium content listed on the pack.  If it is greater than 7%, avoid taking that food(s). If you have been eating in a restaurant, then you find that a certain recipe is high in salt, stop taking that food! Your blood pressure may also rise up if you take  foods rich in fats. Hence, avoid them.

(To be continued)

Symptoms that could prevent you from doing physical exercises (2)

The Symptoms

Fast heart rate

You will surely know when your heart rate is faster than normal. Others call this sudden increase in heart rate as palpitation, and lately this has been used to refer to this medical situation. If you have palpitation—whether taking place so suddenly or has been there for some time—you need to have medical consultation because, if you do not, your heart will suffer. In some people, palpitation takes place when they have taken a cup—or more—of coffee. When this takes place, all you have to do is wait until the effect of caffeine which is so preponderant in your coffee wanes, and your heart rate returns to normal. However, if your heart rate has been so fast for some time compared to your previous ones, then you need to see a medical doctor because you might have a problem in your thyroid gland, and you will need medication(s) to control it. If your heart rate is fast, refrain from having physical exercises because it will increase all the more if you do. Return to having physical exercises only once your heart rate is restored to normal.

Swelling of the legs

If you have swollen legs, it could mean a lot of things. Foremost, it is possible that you have kidney or heartdisease. Thus, you need to consult a medical doctor who will work you up and find your problem. By doing physical examinations, your medical doctor could immediately determine if you have a heart disease. More often than not, if you have swollen legs and you have a history of high blood pressure, your heart has been enlarged, and it is beginning to fail. In another saying, you are starting to have heart failure. Therefore, you are not allowed to have physical exercises for the moment, and you will need clearance from your medical doctor before you can return to the gym.

The other possibility is you have been suffering from kidney disease. Hence, your medical doctor will request you to undergo a urine test which is popularly known as urinalysis. Urinalysis is a very simple test, and it is very cheap. However, your medical doctor could derive a lot of information from it. If your problem is a simple infection, you will be prescribed with the most appropriate antibiotic(s), and you can return to the gym after controlling the infection. In some instances, however, the problem is irreversible or untreatable. In such case, you will be barred from returning to the gym, especially if there is difficulty in controlling your blood pressure.

Difficulty in sleeping

In some people, difficulty in sleeping is being experienced. Medically, this is known as insomnia. If you are one of them, then you need to consult a medical doctor because lack of sleep could cause accident while you are doing work out in the gym. There are a number of possibilities to consider if you have insomnia. Firstly, you might have anemia—a blood disorder wherein the number of your red blood cells is low. If you have anemia, your heart rate is usually faster than normal; this prevents you from falling asleep. Secondly, you might have a problem in your thyroid gland which could be hyperthyroidism. If you have been suffering from hyperthyroidism, your heart has been being overworked, aside from the fact that you have been experiencing insomnia. Hence, if you have been suffering from insomnia, consult a medical doctor at once so that you could be prescribed with the necessary medication(s). Do not insist on having your physical exercises, lest you will meet accident or aggravate your medical condition.

Role of cholesterol in the development of cardiovascular diseases(Part 2)

Anatomy of the blood vessel wall

You have three types of blood vessels: (1) arteries, (2) veins, and (3) capillaries. Your arteries carry the blood from your heart and deliver them to different parts of your body. You veins collect the blood from the different parts of your body and return it to the heart. Your capillaries, on the other hand, connect your network of arteries to your network of veins.In the development of hypertension and heart diseases, the type of blood vessels that are primarily involved are the arteries.Therefore, the center of discussion in the next few sections will be on them.

Your arteries can be likened to your water pipes at home. They are tubes wherein fluid passes through. In your water pipes, water passes through them; in your blood vessels, blood will pass through them. Your arteries are relatively thick tubes, and they are made this way because they need to withstand the high pressure generated by your blood and the regularpumping of your heart.

Tunica adventitia

The wall of your arteries are made up of three layers: (1) tunica adventitia, (2) tunica media, and (3) tunica intima, also known as the endothelium.The tunica adventitia is the outermost layer, the tunica media is the middle layer, and the tunica intima is the innermost layer. The tunica adventitia is responsible for attaching your arteries to the surrounding tissues, thereby preventing them from moving astray. In addition, it provides some strength for your arteries. The tunica media is mainly responsible for providing the strength of your arteries to contain your varying blood pressure. Meanwhile, the tunica intima provides the internal lining of your arteries.

Important role of the tunica intimaor endothelium

Since the tunica intima or endothelium is the innermost lining of your arteries, it is in intimate contact with the flow of your blood. As your blood flows in your arteries, your endothelium offers a frictional resistance to such flow; therefore, the endothelium receives the brunt of the flowing blood. In the parlance of medicine, this is called the shearing effect of the flowing blood. When your blood pressure is very much increased compared to the normal values, this shearing effect also increases, and your endothelium will be injured. The higher the blood pressure is, the higher and more serious the injury to your endothelium will be. This injury will be the beginning of developing the so-called atherosclerosis wherein fatty substances are attached to the lining of the endothelium, giving rise to inelastic arteries which will, in turn, lead to the development of hypertension and heart diseases.

Injury to the endothelium and high level of LDL-cholesterol

In the development of atherosclerosis (deposition of fatty substances in the endothelium), it has been established that the first stage in the process is the infliction of injury to the endothelium.This injury to the endotheliumare caused by increased blood pressure and the increased level of LDL-cholesterol[1]. Hence, if you have elevated blood pressure and you have elevation of the LDL-cholesterol, your hypertension will get worse as days go by, if you do not take medicines to control your high blood pressure and the elevated level of LDL-cholesterol.

The LDL-cholesterol has dual effects in the causation and worsening of atherosclerosis. Firstly, it decreases the production of nitric oxide which is responsible for the dilation of the arteries[1]. Thus, in the absence of nitric oxide, you are prone to have elevated blood pressure because of constriction of your arteries.Secondly, with increased level of LDL-cholesterol in the blood, these fatty substances, together with platelets, could attach themselves in the injured sites in the endothelium. This will make the arteries inelastic and obstructed—be it partial or total—leading to the development of hypertension and heart diseases.

Reference:

Davigon J, Ganz, Peter. Atherosclerosis: evolving vascular biology and clinical implications, role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109: III-27-III-32. doi:10.1161/01.CIR. 0000131515.03336.f8.

Role of cholesterol in the development of cardiovascular diseases(Part 1)

Nature of cholesterol

Cholesterol is a form of fatty substance needed by your body for the maintenance of cell membranes,and production of bile acid and hormones[1]. With insufficient cholesterol, your cells will be adversely affected because the integrity of the cell membrane which encloses all its structures will be impaired. In addition, the quality of your bile acid which is one of the components of your bile and the different hormones that you need every minute of your life will deteriorate.

Cholesterol can be sourced from: (1) the foods and drinks that you take, and (2)the different chemical reactions taking place in your body. Because it is produced in your body, it has been postulated that probably you do not need the cholesterol coming from your foods and drinks! Hence, the cholesterol being produced in your body is enough to meet your needs[1]! However, it is not possible to totally remove all the cholesterol that is in your foods! It is impossible! Thus, if you want to control your dietary intake of it, you need to be choosy with your foods, selecting only those which are not rich in it (Consult Powertec 144). Examples of foods rich in cholesterol are meats, liver and other organ meats, dairy foods, egg yolks, and shellfish[2].

Transfer and elimination of cholesterol

When cholesterol is absorbed in your gastrointestinal tract, it travels in the bloodstream in the form of lipoproteins. It cannot travel as cholesterol; it has to be in the form of lipoproteins. There are two lipoproteins that carry cholesterol: (1) the low density lipoprotein (LDL) and the (2) high density lipoprotein (HDL). The LDLcarry the majority of cholesterol, around 75 to 85%, while the HDL carry approximately 15 to 25%[1]. Thus, they are called either LDL-cholesterol or HDL-cholesterol.

Aside from having different densities, the LDL-cholesterol and the HDL-cholesterol have different behavior when they are in the bloodstream. The LDL-cholesterol tends to bring the cholesterol away from the liver; that is, it brings its passengers to the far-flung structures of the body, such as in the blood vessels and peripheral tissues. Consequently, the cholesterol molecules are deposited in these organs. Specifically, when the cholesterol molecules are deposited in the inner lining of your medium to large blood vessels, these structures become inelastic, leading to the development of hypertension. When they are deposited in the small blood vessels of your heart, you will have heart disease and possible heart attack[3]. Since the LDL-cholesterol contributes to the development of cardiovascular diseases, such as hypertension and heart diseases, it is also known as the bad cholesterol.

The HDL-cholesterol, on the other hand, carries cholesterol molecules from the peripheral organs, such as the muscles and blood vessels, and brings them back to the liver—otherwise known as the reverse cholesterol transport—where they are taken up and incorporated as part of the bile. In a way, these cholesterol molecules were removed from the bloodstream, without inflicting any damage to the blood vessels and other organs of your body. Since the HDL-cholesterolhelped to remove cholesterol in the blood, it is also referred to as the good cholesterol.

Injury to the inner lining of blood vessels and cholesterol deposition

The innermost layer of your blood vessels is called the endothelium, and lately this structure has been receiving a lot of research attention because it has been becoming more clear that it is very much involved in the causation of atherosclerosis (deposition of fatty substances in the blood vessels) andhypertension. It has been postulated that the deposition of fatty substances is preceded by the injury of the endothelium.

(To be continued)

References:

  1. Sacher, Ronald A. and Richard A. McPherson. Widmann’s Clinical Interpretation of Laboratory Tests. F. A. Davis Company, Philadelphia, 2000.
  2. http://www.nhlbi.nih.gov/news/spotlight/fact-sheet/questions-and-answers-cholesterol-and-health-nhlbi-nutritionist-janet-de-jesus-ms-rd
  3. http://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html

Relationship between the intake of saturated fats and the development of cardiovascular problems

Nature of saturated fats

Saturated fats (SFs) are also known as saturated fatty acids. They are found in meats, coconut, palm oil, palm kernel oil, butter, egg yolks, milk, and milk products (except fat-free) [1] {Consult Powertec 63}.SFs come in different names, and examples are formic, acetic, propionic, butyric, valeric, caproic, caprylic (octanoic), capric (decanoic), lauric, myristic, palmitic, stearic, arachidic, behenic, and lignoceric[2]. Thus, if a food product that you are buying contains one or more of these, then you know that it contains SFs, and the best way to find out the SFsincorporatedin any grocery product is to look at the “Nutrition Facts” wherein the different substances contained in it are listed, including the quantity in terms of percent.

Relationship of saturated fats with cardiovascular diseases

It has been established from researches that if your diet is high in SFs, the level of your low-density lipoprotein(LDL) cholesterol is also high[3]. You should remember that LDL cholesterol is also known as the bad cholesterol, because it carries cholesterol away from yourliver and deposited them to far-away structures, such as the blood vessels. When LDL cholesterol is deposited in the internal lining of the blood vessels, atherosclerosis takes place, and the blood vessels become inelastic, leading to the development of hypertension.

Neutralizing the adverse effects of saturated fats

Substitution of saturated with polyunsaturated fats

One of the ways of counteracting the adverse health effects of SFsis to replace them with the polyunsaturated fats(PFs). If PFs are taken in instead of SFs, the LDL cholesterol decreases, and the ratio of total cholesterol with the high density lipoprotein (HDL) cholesterol, which is known as the good cholesterol, decreases, too [3],           implying that either the total cholesterol decreases, or the HDL cholesterol increases, or both scenario happen. When the LDL cholesterol decreases and the HDL cholesterol increases, the combination is a perfect recipe for the prevention of heart and blood vessel diseases.

PFs are abundantly found in safflower oil, soybean oil, sunflower oil, soybeans, tofu, and fish[1]{Consult Powertec 63}. In simpler terms, what you will do is to replace meat with fish, and replace animal-based cooking oil with the ones taken and derived from plants.

 

Avoidance of replacing saturated fats with carbohydrates

When carbohydrates are used to replace SFs, it was found out that the level of both the triglycerides (another form of fat) andLDL cholesterol are elevated in the blood while the HDL cholesterol decreases. These consequences are all the more pronounced if the carbohydratesare refined and added with sugar[3]. This is bad for the heart and the blood vessels. Thus, it should be avoided.

Dietary cholesterol should be avoided if significant saturated fats have been in the diet

Based on animal researches, it was determined that if the dietary cholesterol has been increased,   the tendency of saturated fat to increase the LDL cholesterol level in the blood is also increased. This means that working alone, saturated fats increase the LDL cholesterol level in the blood. If the intake of dietary cholesterol is increased, it will aggravate the LDL cholesterol-raising effect of saturated fats. Therefore, as much as possible, the simultaneous intake of significant amount of dietary cholesterol and saturated fats should be avoided [3].

Foods rich in cholesterol are the following: eggs, roast beef, leg lamb (lean), leg lamb (lean and fat), pork chop (lean), chicken leg (fried, meat and skin), crabmeat (canned), salmon (canned), shrimp (canned) [1]. You need to avoid taking these foods if you have been taking a lot of saturated fats.

References:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.
  2. Murray, Robert K., Daryl K. Granner, Peter A. Mayes, and Victor W. Rodwell. Harper’s Biochemistry. Appleton and Lange: Stamford, Connecticut, 2000.

Siri-Tarino, P., et. al. (2010). Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. http://www.ncibi.nlm.nih.gov/pmc/articles/pmc2943062/